Low vitamin D levels can play a role in sudden, unexplained deaths.
Researchers examined 52 postmortem cases of children aged 2 days to 10 years, of whom 17 had vitamin D deficiency (<25 nmol/L); 24 had vitamin D insufficiency (25-49 nmol/L); 10 had suboptimal vitamin D levels (50-79 nmol/L); and 1 had adequate levels (≥80 nmol/L). They took blood samples and radiographs to check for fractures, which were found in 3 infants.
Three children (2 infants and a 3-year-old ) with vitamin D deficiency died of hypocalcemia; all the children had radiologic and histologic evidence of rickets. The 2 infants had cardiomyopathy, and the 3-year-old had had hypocalcemic seizures.
Ten children with vitamin D deficiency (59%) had abnormalities on histologic studies of the growth plate, but only 3 had abnormal radiographs. Eight infants with vitamin D insufficiency (33%) had abnormal growth plate histology but normal radiology. A high proportion of children in all ethnic groups had low vitamin D levels.
Low vitamin D may be a significant risk factor in bone fractures in children and various diseases including infections and asthma, the researchers say. They note that postmortem vitamin D levels, which are stable and easy and inexpensive to measure, might yield valuable insight into sudden, unexplained childhood deaths as well as asthma deaths and fractures in infants.
To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics PediaMedia.